Depression

It is estimated that as many as 350 million people are suffering from some form of depression and some experts claim that up to a staggering 80% of them are not seeking any kind of treatment. Women are twice as likely as men to suffer from depression, although the risks for men increase with reduced testosterone levels in middle age. So how can you tell if someone is suffering from depression? What are the symptoms?

One of the big problems is that the list of possible symptoms can be as different as individuals and as unique, as can the level to which the signs are noticeable to others. But here are some of the more commons signs and some of the misconceptions associated with them:

Giving off an air of ‘doom and gloom’
True, many depressed people do exhibit what many would consider the classic symptoms of being depressed, but not always. Many depressed people work extremely hard at hiding their ‘doom and gloom’ from others. Sometimes they like the distraction of laughter to take them away from their depressing thoughts and mood, while at other times it’s a massive struggle to force themselves to attend social events. Yet, when they are there, their protective instincts go into overdrive to give the impression that all is well.

Feeling sad all the time
Only partially true. Depression is not necessarily about ‘feeling sad’. It’s often about not feeling anything, or only partially experiencing the full range of emotions. It depends on the individual, some people say they feel numb, others only experience a kind of irritability. Alternatively, some people experience extreme lows without the corresponding highs. The most common anti-depressant drugs work by reducing the scale of the highs and the lows so there is a more even reaction to events. Of course, ironically, this can also contribute to a feeling of numbness. Depression has its ups and downs so it’s tempting to believe people are improving after a couple of ‘good days’. Pestering or pushing them too quickly to do things may have the opposite effect and cause them to retreat into their depressed state again, and you also run the risk of them getting irritated with you, or even worse, making more effort to hide their true feelings from you.

‘It’s all in their head with no physical symptoms’
This is almost never true. Long periods of depression take their toll on the body, and as a result, physical symptoms start to develop. Our minds and bodies are inextricably linked so any kind of sickness in one, can manifest in the other.
Some of the more common physical symptoms are:

Inexplicable headaches or pain.

Disturbed sleep patterns or insomnia. Sometimes they can sleep for hours and still wake up exhausted.

Fatigue and lack of energy.

Weight issues. This can be eating too much, too little or eating badly. Eating too much can be a substituted source of pleasure, eating too little can be due to a suppressed appetite or an attempt to control at least one aspect of their lives, and eating badly can be because eating healthily is just not important to them anymore.

Apathy or loss of interest in things they used to enjoy. Depressed people often complain that ’nothing is fun anymore’.

Lack of self care.

Unusual irritability – this can be caused by the enormous strain of dealing with their other symptoms.

And as if to exacerbate these symptoms, depressed people are less likely to follow a diet, take medication or exercise.

There is still a great deal of ignorance, assumption and stigma associated with depression, which causes us to either ignore the symptoms or to mis-diagnose them. In some cases the condition goes unrecognised because of false assumptions about how depressed people are ‘supposed to behave’. Their suffering is not always obvious and indeed many people go to great lengths – and expend considerable energy – hiding their true feelings and mood.

If you suspect a loved one or a friend is suffering from depression it is important to encourage them to be correctly diagnosed and to seek help. It’s perfectly normal to feel dejected or unhappy after a loss, a bereavement or a disappointment, and loneliness or financial worries can all feed this sense of unhappiness. This does not necessarily mean they are depressed. The symptoms listed above can all occur for many reasons other than depression but when many of them occur at the same time, or when they start to become the person’s normal state, then it’s time to seek advice from someone qualified to give it.

Despite increasing awareness of depression, and other mental health issues, there is still a belief that a physical illness trumps a mental one in terms of how much sympathy and support a person gets. There appears to be a marked reluctance to accept depression as a ‘real illness’ which is bizarre given how often it is a factor in suicides. Advice from seemingly caring loved ones or friends can be at best, a mixed blessing, and at worse, damaging.

Here is a list of just some of the ‘helpful’ advice which can be infuriating to someone suffering from depression:

“Snap out of it” – Oh that it was that simple! Even summoning the energy to ‘snap’ anything would be a bonus.“Cheer up” – It’s not about sadness and it certainly can’t be turned on and off like a tap.“You just have to grin and bear it” – No you don’t. There are people and resources which can help.“Life is tough and there are others worse off than you” – True and they deserve to get as much help as possible, but so do you. Their suffering is in no way related to yours. And do you really know how tough life is for anyone else?“You worry too much. It may never happen” – This isolates the person and make them think it’s their fault. To them it already has happened and they are feeling the pain of it.“Life goes on and you need to get out and enjoy yourself” – A depressed person often knows they ‘should’ go out more but they ‘can’t’ and ‘enjoying themselves’ is often no longer within their control. However, arranging to go out with them can help in some circumstances.“Stop feeling sorry for yourself, you’ll be fine” – With appropriate care they may very well be fine but it’s not about feeling sorry for anyone. There is often an enormous internal struggle going on not to accept their condition, never mind feeling sorry about it.“Why don’t you take a few tablets” – No, No, No. Leave prescribing medication to the professionals and even then there is a strong body of opinion which opposes automatic drug use for all depression. Overuse of alcohol goes into this category too.“You should be feeling better by now” – Says who? You? – a person who is clearly growing impatient with your friend’s illness.

So if you genuinely care and want to help, here are 20 things you can do:

Inform yourself – learn what you can about depression.

Be supportive without being judgemental. They need to know people are in their corner in what may well be the biggest fight of their lives.

Do not apportion blame or criticism, to them or anyone else for causing their illness.

Don’t assume they are better after a few good days.

Encourage them to stick to daily routines to increase the chances of them getting enough sleep, food and exercise.

Talk to them about whatever they want to talk about, even if that takes the conversation into some dark places. And more importantly, listen and actually hear what they tell you.

Don’t underestimate how much effort is going into their everyday lives.

Accept it takes great courage to admit you are suffering from depression and even more strength to ask for help in coping with it.

Appreciate how much they are trying not to be a burden or to worry their loved ones. This is sometimes what pushes them into being alone because the effort of ‘pretending’ is often too great.

Do not treat them as if they are attention seeking – attention is often the last thing they are seeking.

Treat them with respect but there is no need to walk on eggshells around them.

Realise that sometimes they want to be left alone but sometimes they appreciate someone showing that they care.

Accept depression can be caused by many things – it does not mean that person is broken.

Don’t assume they have the same energy levels as they once did, but encourage them to exercise as sometimes they lack motivation, not energy.

Accept that they might be inexplicably sad or irritable. They are sad and irritable at the way they feel, not at you, so don’t react and cause an argument.

Acknowledge they are stronger than you might expect and are not planning on losing the fight against depression.

The first step is to acknowledge its presence, seek advice and treatment. Denial can be the biggest obstacle to removing depression from your life.

For more information about how Mind In Sync can help people suffering from depression or for advice on how to help sufferers in Herts,Beds and Bucks please email info@mindinsync.co.ukor call 07885 350469.